How to Find Your Dream Position

by Peter Olson

When researching and applying for positions, the first important thing to do is to change your thinking.

During your applications for medical school and residency, the goal was to be accepted. By contrast, during your search for a job you are also deciding whether a position will be a good fit for you in the long term.

They’re not just screening you, but you’re screening them too.

Imagine your ideal position

Before you start considering positions, you should decide what is a “must-have” and what is a “nice-to-have” when deciding which offer to take.

Knowing what is most important to you will help when you start your job search.

Think about aspects of the job such as the geographic area, lifestyle preferences, patient volume, current job market, and practice type.

Even if something seems like an impossible demand, put it on your list anyway. It’s a goal to aim for that will help shape your decision in a positive way.

When deciding what makes your “ideal position,” consider aspects of the position such as the types of patients and cases you want to see and the number of hours a week you’d like to work.

Think about the pay and benefits you’re looking for, how big of a group you’re seeking, and the sort of work environment you’d like best.

Finally, the type of geography you’re interested in can play a difference in the type of setting you will be able to practice in.

For example, if you want to practice in a rural area you may have to start a solo practice, as your area may not have the additional physicians needed to form a group.

And in many cases, new physicians seeking to move to large metropolitan areas, especially in the northeast, may have fewer opportunities and lower compensation when compared to other areas in the country.

This is because there is a glut of job seekers. It’s not surprising that the states with the highest concentration of physicians (all in the Northeast and Mid-Atlantic) also had the lowest compensation rates.

So be careful if you are using geography as the most important determiner of your dream position.

A Jackson and Coker survey found that physicians who chose “location” as the most important concern in their first job search were more likely to leave within five years than those applicants who chose “quality” as their priority.

By keeping all of these factors in mind when describing your dream position, you will be able to compare that description with the positions for which you interview and see how much overlap you can get.

Employer types

Each type of employer, from universities to HMOs to hospitals or private practices, will have its own unique pros and cons.

When deciding where to work, think about the compensation, risks, benefits, opportunities, technology, call, ownership, duties, marketing, and staff.

Solo practice: a practice without partners or affiliations with other practice organizations. These usually have a small staff and patient base.

The smaller size gives you the advantage of greater autonomy, as you are able to design and develop the practice without having to answer to anyone else.

On the other hand, the entire burden of running the practice is entirely on you. This includes medical care as well as business burdens like dealing with insurers and compliance documentation.

Solo practices can be more financially risky due to business costs, the small patient base, and any lost income caused by illness or vacation.

Suburban or rural areas can be better for solo practice because of more significant medical need and less competition from other medical resources.

Group practice: typically divided into single-specialty and multi-specialty practices, with more than one physician providing patients with care.

Group practices offer greater financial security than solo practices due to the larger number of physicians and increased size of the patient base.

Group practices also usually have the resources to manage the administrative tasks associated with running a practice. This is not an insignificant advantage, as this function has become increasingly important in the healthcare industry.

Also, the increased number of physicians spreads the burden of clinical care across a greater number of people, which allows more scheduling flexibility.

However, autonomy decreases with the size of the group.

Organizational and operational differences should be taken into consideration when deciding which type of organization you want to work for.

Employed physician practice: an advantage of being an employed physician is that much of the administrative burden of running a practice is shifted to the employer, allowing clinicians to focus more on practicing medicine.

Also there is usually a baseline level of assured compensation, although there may be productivity demands and incentives.

Because of the larger number of physicians, there are usually more resources available than in solo or independent group practices.

The downside is that physician autonomy may be substantially diminished relative to other practice models. There may be less clinical flexibility and more outside expectations, such as serving on committees or participating in other organizational activities.

There are various types of employed physician practice settings, like hospital-based and HMOs.

Hospital based physicians may work in a department of the hospital, or in a practice owned by a hospital. One advantage of this type of setting is access to a hospital, an established patient base, a dependable salary, the support of other physicians, and management and administrative support.

However, autonomy can also be somewhat limited in hospital settings.

Physicians working in an HMO setting are paid as employees and may receive bonuses based on production, resource utilization, and patient satisfaction scores.

HMOs offer a more predictable lifestyle with set hours. The administrative side is less onerous, as other HMO employees handle billing and regulatory issues.

As in other employed physician practice settings, autonomy is more limited.

All of these organizational and operational differences should be taken into consideration when deciding which type of organization you want to work for and also to evaluate the contract you receive.

How to find jobs

Most begin a job search during the final year of residency or fellowship, so it’s a good idea to have your ideal job description completed early during your final year of training. In fact, search firms recommend starting a year before your training will end.

If you wait too long, you can end up accepting a job out of necessity rather than choice.

So during your last year of training, really start to get serious about your job search.

There are various ways to apply for jobs, from conferences, colleagues, recruiters, websites for physicians, and the professional society for each specialty.

Networking is still an important way to find a job, but there are increasingly opportunities listed on online physician job boards.

Physician job fairs and recruiters can also be excellent resources.

As you begin your job search, keeping that ideal job description in your mind will help you to navigate everything from networking at conferences to working with recruiters.